Only the use of cloxacillin-containing Mueller-Hinton agar plates (200 [micro]g/mL) to inhibit the activity of the naturally occurring cephalosporinase
(AmpC) allowed detection of a synergy image, signature of the presence of an ESBL (5).
chromosomal AmpC cephalosporinase
induction/derepression or porin modification) as the basis in Enterobacter species.
inhibited by clavulanic acid; carbapenemases inhibited by clavulanic acid) Oxacillin-hydrolyzing, OXA; cloxacillin; ESBL cephalosporins; weak activity for carbapenems (e.
aeruginosa is an inducible cephalosporinase
that confers resistance to all betalactams except the carbapenems.
alteration of penicillin binding site, beta-lactamase and extended-spectrum beta-lactamase-producing organisms via chromosomal-inducible enzymes and cephalosporinase
, ribosomal site alteration, efflux mediated mef E (high level) and target modifiable erm AM mediated (low level) resistance, alteration in the binding site of a specific transpeptidase (mec A) in methicillin-resistant S.
Penicillin and cephalosporins are not recommended for initial treatment due to the demonstration of a cephalosporinase
and an inducible penicillinase in the anthrax genome.
was slightly more active against cephalosporinase
as compared to clavulanic acid.
The susceptibility pattern with regard to cefepime probably reflects excellent activity against chromosomal-located cephalosporinase
The DDST was also performed on MH agar plates (bioMerieux) containing cloxacillin (150 mg/L) to inhibit cephalosporinase
activity of natural producers of those inducible cephalosporinases
The Carba NP test perfectly differentiates carbapenemase producers (Table 1) from strains that are carbapenem resistant due to non-carbapenemase-mediated mechanisms, such as combined mechanisms of resistance (outer-membrane permeability defect associated with overproduction of cephalosporinase
and/or extended-spectrum P-lactamases) or from strains that are carbapenem susceptible but express a broad-spectrum [beta]-lactamase without carbapenemase activity (extended-spectrum [beta]-lactamase, plasmid and chromosome-encoded cephalosporinases
) (Table 2).
NDM-1] gene are diverse and can harbor a high number of resistance genes associated with other carbapenemase genes (oxacillinase-48 [OXA-48] types, VIM types), plasmid-mediated cephalosporinase
genes, ESBL genes, aminoglycoside resistance genes (16S RNA methylases), macrolide resistance genes (esterase), rifampin (rifampin-modifying enzymes) and sulfamethoxazole resistance genes as a source of multidrug resistance and pandrug resistance (16,17) (Figure 2, panel B).